POS0023 PREVALENCE AND IMPACT OF FIBROMYALGIA SYNDROME IN A COHORT OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Authors: L. Guida, S. Sirotti, G. Filippou, A. Dell’era, D. Gridavilla, M. E. Romano, D. Ventura, G. M. C. La Paglia, S. Farah, S. Ardizzone, P. Sarzi-Puttini
Journal: Annals of the Rheumatic Diseases (2022)

Background Fibromyalgia (FM) is a common chronic disorder characterized by widespread pain, fatigue, sleep disturbances and functional symptoms, reaching a prevalence of 2–3% worldwide. It can present as a comorbidity in patients with concomitant chronic disease and can have a significant impact on the quality of life. There are very few studies on the prevalence and the impact of FM in patients with inflammatory bowel disease (IBD). Objectives The aims of this study were to assess the prevalence of FM in a cohort of patients with IBD, and to evaluate the impact of FM on the quality of life of those patients. Methods Consecutive patients with IBD were enrolled from August to November 2021 in two IBD units, patients with severe disease activity according to the Crohn’s disease activity index (CDAI) and to the Mayo score for UC, or with other concomitant chronic diseases were excluded. Clinical and demographic data and Patient Reported Outcomes (PROs) (Widespread Pain Index (WPI), Symptom Severity Score (SSS), IBD Questionnaire (IBD-Q), Depression anxiety stress scales-21 (DASS-21), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Impact of event scale-revised (IES-R), Pittsburgh Sleep Quality Index (PSQI)) were collected. FM was diagnosed according to 2011 ACR classification criteria by an expert rheumatologist. Mann-Whitney test, chi-square test, and Student t test were used for statistical analyses. A multivariate analysis was performed to estimate the effect of independent variables (BMI, age, CRP, CDAI, Mayo score, WPI, DASS-21, FACIT-F, PSQI) on patients’ quality of life (IBD-Q). A p value &lt; 0.05 was considered as significant. Results A total of 196 IBD patients were enrolled (86 female (44%) with a mean age of 50 ± 15 yo), 105 with Crohn’s disease (CD) and 91 with ulcerative colitis (UC). 147 patients were in remission, 35 had low disease activity and 14 moderate disease activity. The overall prevalence of FM in the IBD cohort was 17/196 (8.7%) [95% IC 5% – 13%], 10 (11.6%) women and 7 (6.3%) men; with a prevalence of 7.6% (8/105) in CD and 9.9% (9/91) in UC. In Table 1 are indicated the characteristics of patients with IBD + FM and IBD alone. No significant demographic and clinical differences between the two groups were detected. Table 1. IBD + FM (n=17) IBD without FM (n=179) p Female/Male (% ) 10/7 (59%/41%) 75/102 (42%/58%) 0.19 Age, years (SD ) 56.8 (± 13) 48.5 (± 17) 0.06 BMI (SD ) 21 (± 8.7) 23.7 (± 4.8) 0.46 CD (%)/UC (% ) 8 (47%)/9 (53%) 97 (54%)/82 (46%) 0.57 CRP, median (SD ) 0.16 mg/dL (± 2.8) 0.2 mg/dL (± 1.5) 0.87 IBD remission 14 (82%) 133 (74%) 0.33 IBD low disease activity 1 (6%) 34 (19%) IBD moderate disease activity 2 (12%) 12 (7%) Ongoing conventional treatment 6 (35%) 70 (39%) 0.27 Ongoing biological treatment 11 (65%) 112 (63%) 0.42 PROs IBD-Q 150.3 176.9 &lt;0.001 DASS-21 DEPRESSION 15.3 8.24 &lt;0.001 DASS-21 ANXIETY 16.6 9.13 &lt;0.001 DASS-21 STRESS 13.4 6.13 &lt;0.001 FACIT-F 25.5 38.2 &lt;0.001 IES-R 36.9 16.3 &lt;0.001 The quality of life among IBD patients and IBD + FM patients, assessed with IBD-Q, appear significantly lower (p &lt;0.001) in the second group. Similar results were obtained evaluating depression, anxiety, stress, chronic fatigue, and patients’ discomfort (Table 1). The multivariate analysis demonstrated that the variables influencing the quality of life (IBD-Q) were the disease activity (CDAI) (p 0.0256), the chronic fatigue (FACIT-F) (p 0.0061) and sleep disturbances (PSQI) (p 0.0440), for CD; while for UC the only variable that correlate with IBD-Q was the disease activity (Mayo score) (p 0.0129). Conclusion FM is a common disorder especially in patients with other concomitant chronic diseases. This study reported a prevalence of FM of 8.7% in IBD patients without any significant differences between CD and UC. Moreover, the comorbidity of FM in IBD can have a considerable impact on quality of life and on measures of disease severity, with worst values in all PROs measurements. Disclosure of Interests None declared